Impetigo: A Common but Highly Contagious Skin Infection

Impetigo remains one of the most frequently encountered bacterial skin infections in both primary care and dermatology clinics. It is most commonly caused by Streptococcus or Staphylococcus aureus, with methicillin resistant Staphylococcus aureus (MRSA) continuing to emerge as an important cause in certain communities.

Although the skin naturally carries many harmless bacteria, infection can develop when there is a disruption to the skin barrier. Even minor trauma such as a small cut, graze, insect bite or persistent scratching can provide an entry point. Once bacteria enter, they multiply and trigger inflammation, resulting in the characteristic blisters and crusting associated with impetigo.

In some cases, impetigo can arise without an obvious visible break in the skin. It is particularly common in young children, especially in nursery and school settings where close contact facilitates spread. In adults, it may occur following another skin condition such as eczema, or develop after a viral illness, including a cold.

Recent Clinical Developments

In recent years, clinicians have observed a gradual rise in antibiotic resistance among Staphylococcus aureus strains, including community associated MRSA. This has prompted updated prescribing guidance emphasising careful antibiotic selection and, where appropriate, the use of topical therapy for limited disease to reduce unnecessary systemic antibiotic use.

There has also been increased emphasis on antimicrobial stewardship. For small, localised patches of non bullous impetigo, topical antibiotics may be recommended as first line treatment, while more widespread or recurrent cases may require oral antibiotics tailored to local resistance patterns.

Additionally, greater awareness of skin barrier care has emerged. In individuals with underlying eczema or other inflammatory skin conditions, optimising skin health can reduce susceptibility to secondary bacterial infection.

How Impetigo Spreads

Impetigo is highly contagious. It spreads through direct skin to skin contact or indirectly via contaminated items such as towels, bedding or clothing. The infection can be transmitted when fluid from a blister comes into contact with broken or vulnerable skin.

Children are often advised to remain at home from school or nursery until they have received appropriate treatment for at least 24 to 48 hours, depending on medical guidance, to minimise transmission.

Recognising the Symptoms

Typical features of impetigo include:

• One or more blisters filled with pus that rupture easily
• Red, raw looking skin beneath a burst blister, particularly in infants
• Blisters containing yellow or honey coloured fluid that ooze and form crusts
• A rash that may begin as a single lesion and spread through scratching
• Sores commonly affecting the face, especially around the nose and mouth, as well as the arms and legs
• Swollen lymph nodes near the site of infection
• Multiple patches of infection, particularly in children

The distinctive honey coloured crusting remains a classic clinical sign.

Treatment and Professional Advice

Prompt treatment is important to shorten the duration of symptoms, reduce the risk of complications and limit spread to others. Management may involve topical or oral antibiotics, depending on the severity and extent of the infection, alongside advice on hygiene and preventing reinfection.

If you suspect impetigo, timely assessment is recommended. A clinical evaluation ensures an accurate diagnosis and appropriate treatment plan, particularly in light of evolving antibiotic resistance patterns.

For expert advice and personalised care, contact Devonshire Dermatology to arrange an appointment. Early intervention supports swift resolution and helps protect those around you.